Individual
DR. BRIAN G SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
13033 S LA GRANGE RD, PALOS PARK, IL 60464-1718
(708) 361-4300
Mailing address
619 N RACINE AVE APT 1, CHICAGO, IL 60642-5465
(626) 319-1165
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031658
IL
122300000X
Dentist
DEN.00204431
CO
Other
Enumeration date
07/19/2018
Last updated
07/23/2020
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